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D2 S PAR 1 > PAR 1 Pharmacology > Flashcards

PAR 1 Pharmacology Flashcards

1
Q

Ketoacidosis cause and tx

A

cause: LOW insulin

tx: insulin

increased ketones lower the pH and increase glucose, leading to hyperglycemic crisis

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2
Q

Sever HYPOglycemia treatment

A

recombinant glucagon

stimulates the liver to release glucose into the blood

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3
Q

Sulfonylureas

A

increase insulin release by blocking K+/ATP channels in beta cells

HIGH RISK of HYPOGLYCEMIA

  • chlorpropamide
  • glyburide
  • glimepiride
  • glipizide
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4
Q

What should you avoid prescribing in patients on sulfonylureas?

A

NSAIDs– could increase hypoglycemia

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5
Q

Meglitinides

A

“-glinide”

increase insulin release from beta cells

control of post-prandial glucose

  • repaglinide
  • nateglinide
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6
Q

Biguanides

A
  • metformin

does NOT affect insulin secretion– NO risk of hypoglycemia

Stimulates AMPKs to reduce blood glucose
- (AMP activated protein kinase)

LACTIC ACIDOSIS RISK

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7
Q

Thiazolidinediones

A

“-glitazone”– rosiglitazone, pioglitazone

Specifically bind PPAR𝝲

increase insulin sensitivity– makes a low concentration have the same effect as a higher concentration

Metabolized by P450

Black box warning to monitor for heart failure signs after starting therapy

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8
Q

Ultra short insulins

A

aspart
lispro
glulisine

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9
Q

Short acting insulins

A

normal insulin

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10
Q

intermediate acting insulins

A

NPH
lente

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11
Q

Long acting insulins

A

detemir
degludec
glargine

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12
Q

What drugs have the potential to cause hypoglycemia?

A
  • insulin therapy
  • sulfonylureas
  • meglitanides
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13
Q

Peptide incretin drugs

A

bind GLP-1 receptors (act like GLP-1)

decreases glycogenolysis caused by glucagon

  • liraglutide
  • albiglutide
  • dilaglutide
  • exenatide
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14
Q

Which peptide incretin drugs are resistant to hydrolysis by DPP4?

A

liraglutide
exenatide

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15
Q

DPP4 does what?

A

hydrolyzes (inactivates) incretins (so insulin is lower)

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16
Q

DPP4 inhibitors

A

increase insulin and lower blood glucose

  • sitagliptin
  • saxagliptin
  • linagliptin

sitagliptin also inhibits inactivation of GLP-1

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17
Q

Colesevelam hydrochloride [Welchol]

A

bile acid sequestrant

  • developed to lower cholesterol, now approved for type II diabetics who are taking other medications

lowers HbA1c and LDL cholesterol

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18
Q

Na/Glucose co-transport 2 inhibitors

A

“-flozin”– canagliflozin, dapagliflozin, empagliflozin

Block glucose reuptake in the kidneys by inhibiting SGLT2

Do NOT use in patients with compromised kidneys

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19
Q

Somatostatin action

A

delta cell secretion

inhibits TSH and GH release from pituitary

inhibits insulin AND glucagon release

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20
Q

Somatostatin drug

A

ocreotide

inhibit insulin in insulinomas

inhibits glucagon in glucagonomas

can also tx acromegaly

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21
Q

alpha-glucosidase inhibitors

A

acarbose, miglitol

reduces uptake of carbohydrates and decreases post-prandial glucose rise

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22
Q

diazoxide

A

potent HYPERglycemic actions

inhibits insulin secretion, but does NOT inhibit insulin synthesis

tx for inoperable insulinomas

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23
Q

Levothyroxine

A

synthetic T4

24
Q

Liothyronine

A

synthetic T3

25
Q

Thiourelyenes

A

inhibit iodination and coupling of iodine (decrease production of active thyroid hormone)

PTU, methimazole (Tapazole), carbimazole (Neo-mercazole)

26
Q

PTU blocks what other rxn different from the other thiourelyenes?

A

PTU also inhibits conversion of T4 to T3

27
Q

Which thiourelyene should you use in a pregnant pt?

A

PTU– because it does NOT cross the placenta, whereas methimazole (Tapazole) does.

28
Q

Thyroid storm treatment

A

Iodine (KI)

  • Iodine (KI) also used as a pre-op treatment
29
Q

Iodine (KI) MOA

A
  • inhibits ALL I- metabolism by the thyroid gland and blocks the release of T3/T4
30
Q

Who can you give reactive iodine to?

A

Adults over 35, no women of child-bearing age

  • beta radiation destroys parenchymal cells of gland
31
Q

Hyperthyroidism treatments (classes)

A

Thiourelyenes
Iodine (KI)
Radioactive Iodine

32
Q

PTH therapeutics

A

raise plasma calcium levels, treats hypoparathyroidism

hPTH (Teriparatide)
Vit. D and dietary Ca supplement

33
Q

Stress releases cortisol, which will….

A

suppress pituitary function, so TSH is not released – causes hypothyroidism

34
Q

Where is calcitonin secreted from?

A

parafollicular C cells of the thyroid

causes a shift to the inactive form of Vit D

  • decreases Ca reabsorption by kidneys
  • decreases bone resorption
35
Q

Hypercalcemia treatment?

A
  • calcitonin
  • hCT
  • prednisone
36
Q

NSAIDs and aspirin can do what in a hyperthyroidism patient?

A

increase T4 levels

37
Q

Calcitriol

A

made in kidneys, active form of Vitamin D

increases calcium and phosphate

induces synthesis of calbindin

38
Q

Calcitriol therapeutics treat what?

A
  • nutritional rickets
  • metabolic rickets
  • osteomalacia
  • hypoparathyroidism
39
Q

Cinacalcet (Sensipar)

A

calcimimetic– **binds allosterically to CaSR… causes PTH suppression at lower [Ca2+]

40
Q

Bisphosphonates

A

“-dronate”

inhibit bone resorption– lower plasma calcium

poor absorption, so you have to take on an empty stomach– can cause erosive esophagitis

41
Q

Which bisphosphonates do not treat hypercalcemia effective orally and need a 4-24 hour infusion instead?

A

etindronate
pamidronate

42
Q

etindronate brand

A

Didronel

43
Q

alendronate brand

A

Fosamax

44
Q

pamidronate brand

A

Aredia

45
Q

ibandronate brand

A

Boniva

46
Q

risendronate brand

A

Actonel

47
Q

zolendronate brands

A

Recast, Zometa

48
Q

Denosumab

A

RANK ligand inhibitor

monoclonal antibody

tx: osteoporosis, metastasis to bone, giant cell tumor of bone

49
Q

Cholecalciferol

A

Vit D3 (fish oils)

50
Q

ergocalciferol (after irradiation)

A

vit D2

51
Q

Calcipotriol

A

DONOVEX– psoriasis

52
Q

Dihydrotachysterol

A

reduced D2– osteoporosis

53
Q

Paricalcitol (Zemplar)

A

reduces PTH Secretion

54
Q

22-oxacalcitriol

A

Suppresses PTH gene expression

55
Q

Calcitriol brand names

A

Calcijex, Rocaltrol

D2 S PAR 1 (2 decks)

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